Notes from PCAC Committee Meeting

Notes from PCAC Committee Meeting

Quality Subcommittee

May 20-21, 2014

What are the common elements found in the various EMR Spiritual Care Assessments? Frequency of times is in (parentheses).

1.  Spiritual care interventions (6)

2.  Type of assessment – initial/ongoing/crisis/sacrament/mediation, A.D./grief (5) (CHE/Trinity)

3.  Religious affiliation (5) (OSF)

a.  Connection with family (4)

b.  Connection with faith community – requests contact with faith community(2)

4.  Needs from chaplain (4)

5.  Assess goal / intervention / outcome (3) (Lancaster)

a.  APIE/SOAP (suffering) (SF)

6.  Ethical issues (3)

7.  Consult / referral to other services (3)

8.  Fear level (severe, substantial, moderate, mild) (2) (SF)

9.  Sense of Holy/God

10.  Peace
Comfort

11.  Spiritual strengths

12.  Role of faith community (meals, grief counseling…)

13.  Physical pain X (hospice-centric?)

14.  Other needs X

15.  Referral source / comment

16.  Future care: with narrative, with types (Dignity Health) (strong interest in this one)

17.  Advance Directives tracking – living will

What are Essential Elements Needed in EMRs?

1.  Referral source/comment

2.  Type of assessment (AKA clinical encounter – better term)

(initial, crisis, mediation, grief work, palliative care)

3.  Assessment model: (SOAP, SOAPIER, APIE, AIE)

Assessment/goal/intervention*/outcome

a.  Key interventions (drop down boxes) top five?

Specific and clear list available to chaplain, i.e. NCCN and others

4.  Free Form Narrative Capability

What elements are essential for measuring a quality chaplain encounter?

1.  Patient Focused

a.  Meaning

b.  Community/support system

c.  Hope/peacefulness

d.  Concept of the Holy, Divine, etc

2.  Referral to others, time to chart (20 minutes of visit)

3.  Clear communication/documentation

4.  Future care

a.  (including entire continuum of care – home, community, wellness, spiritual integration network)

5.  Accessible to all

a.  Transparent, to patients, colleagues, care teams

6.  Inter-disciplinary team focused

a.  including complementary healing disciplines

7.  Tool is accessible in all settings

o  clinics, acute, clinical, home care, hospice.

EMR Quality

1.  Spiritual care data can be easily reviewed, extracted for periodic chart review for (CQI) – viewed by others.

2.  An expectation should be set for regular chart reviews by the spiritual care department and other disciplines for quality input, and to identify new needs and improve patient satisfaction. (Criteria template for chart review - using current chart review teams in quality departments)

3.  Quality includes: Survey input of providers, caregivers, I-teams on usefulness of quality of chaplain interventions and notes…champions and challengers

4.  Provisions are made to continue to improve, update, fine tune EMR.

5.  Spiritual care departments regularly provide ongoing education on quality document.

6.  What is the identity of the chaplain?
What is changing about “our identity”? Challenging it?
Patient focus, need is changing, care. Who’s need?
(i.e., patient requests phone call, managing assumptions)

Key Quality Question

−  What are the Core Elements of an EMR spiritual assessment (EMR specific)

−  Spiritual integration network is known, created, identified in each community – population health (i.e., chaplain, spiritual care c companion, faith community RNs, faith communities, medical neighborhoods, wellness centers, support groups – grief, loss, change) Direct and indirect contact (1:1, Groups, tele-chaplaincy)
Asynchronous: Web pages comfort
Patients, create space for patient healing
Comfort care (Counting starts**prayer page)

Prayer line of recorded prayers.